- Member of Parliament
- Member of Parliament
- Bloc Québécois
- Montcalm
- Quebec
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- May/9/24 12:06:20 p.m.
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- Re: Bill C-5
Madam Speaker, in today's debate, we must not forget the over 42,000 people who have died. We must also not forget their families, who have suffered as they watched their loved ones get caught in a downward spiral. I want us to have a respectful debate, where we do not use people who are sick and suffering to further a political or ideological agenda.
I want us to work on solutions, while respecting frontline workers and hearing and listening to what they have to say. For some weeks now, at the Standing Committee on Health, we have been hearing from witnesses, experts, people who work with individuals who struggle with addiction. They have been telling us about the situation.
What we can say today is that substance abuse, multiple substance abuse, is not a simple problem, and it is not first and foremost a judicial problem. It is a severe and complex public health issue. I think everyone can agree, or at least I hope they can, that drug addiction is a very insidious, chronic and multifactorial illness.
At one time, it could be said of addicts that they were slowly making their way to hell. The introduction of a synthetic opioid, fentanyl, has now tragically reduced the length of that journey. That is why I think that, in 2024, we need to call it an illicit drug crisis. That is what is causing overdoses.
This is a complex issue, and simplistic solutions are not the answer. Between 50% and 70% of addictions are associated with primary mental health problems. People need better access to first-line treatment. I will get back to this later, but the lack of investments in health care is not helping. We cannot solve a problem, discuss a problem, find solutions to a problem or measure the effectiveness of these solutions without first agreeing on the concepts involved in addressing it.
I am totally stunned this morning. I always thought that the Conservatives and the Leader of the Opposition deliberately spoke in vague terms, that they wanted people to believe that all of the parties except theirs were in favour of legalizing hard drugs. That is no small thing.
If, on their criminology 101 exam, an applicant to the criminology department was asked the difference between legalization, decriminalization and diversion and they gave the answer the Conservative leader gave earlier, that they are all the same thing, that they are just synonyms, that we are using different words that mean the same thing, that person would be rejected.
How can anyone talk about a problem when they do not even understand the concepts needed to describe and discuss reality? There is no one in the House right now who thinks we should legalize hard drugs to deal with the illicit drug crisis.
The problem, as we will see later in the analysis of the Conservative motion put forth this morning, is that the concept of legalization is being used indiscriminately. Legalizing drugs leads to the commercial production of the substances in question. All drug-related offences are removed from the Criminal Code to allow people to use drugs. It could result in commercial production and sales and freedom of purchase and use, as was the case for cannabis. Can we agree that that is far from what we want?
Decriminalizing simple possession for personal use by an addict is not at all the same thing. Can we agree on that? If we cannot agree on that, where is this debate going? What are we talking about, exactly?
Decriminalizing drug use, and by extension avoiding making a person suffering from addiction go through the judicial process, is not the same thing as legalizing drugs. It is a way of destigmatizing the addiction and giving the addict, among other things, access to services and resources. For people to get to rehab, when that is what they want, we need to be in contact with them. If they are using drugs in secret, if they cannot talk about their addiction for fear of being stigmatized at work, does anyone think they will openly ask for help if they can be criminally charged? If they were unfortunate enough to take a pill from an illicit laboratory, they could die.
What people need to know is that this disease involves relapses, and no one ever wants to talk about that. People think all it takes is a stint in rehab and the problem is solved. That is not true, because relapse is part of the healing process.
It is a complex problem. Let us imagine managing to convince someone to go to rehab. Relapse is part of the process. Let us then imagine that that person no longer has access to supervised drug sites, which is what the Harper Conservatives proposed in 2011. The Supreme Court refused and said it was important because it would be injurious to the safety of people suffering from drug addictions. If a person relapses and no longer has access to these sites, they will take illicit drugs and will have less tolerance to the drug because opioids create a dependency. They could die. People talk about harm reduction, and those who work in the field say that supervised drug sites play an important role in harm reduction. Why is that? Because of illicit drugs. They can be tested to see if they contain fentanyl.
Of course, we need to deal with the issues arising from sharing spaces in the community. People who do not have a drug problem should not be left holding the bag. However, that does not negate an entire strategy based first and foremost, let us not forget, on prevention. It is not simply a matter of preventing drug use. It is also a question of preventing relapses, avoiding stigmatization and fostering social reintegration.
There is an incredible new project in my riding: a refurbished Uniatox. I am a little emotional. For the first time, this organization is going to work toward preventing relapses. There are not a lot of projects like that.
An utterly simplistic approach would be to stay away from harm reduction altogether. Just send people to detox, and then expect them to man up or woman up and deal with their life issues. This, however, is not the way to go. People will relapse. Supervised consumption sites do help people stabilize their drug use.
Harm reduction is one of the four pillars. I also talked about prevention. In this opioid crisis, a single pill can kill a person, so recriminalizing drugs will not solve the problem. That has absolutely nothing to do with it. I could go out on the street right now and get a black market pill. It has nothing to do with decriminalization.
There are a lot of overdoses in British Columbia, Alberta, Ontario and New Brunswick. Quebec does not have quite as many, according to the statistics I saw, but we have to be careful with that. Harm reduction also means safe supply. Why? Because we need to save lives, because illicit drugs kill. As far as I know, the fourth pillar, enforcement, is still not very effective.
In fact, for 50 years the repressive war on drugs approach solved nothing. If we compare the U.S. model to Portugal’s, we see that the United States is far behind. Still, is there a country more hostile to decriminalizing simple possession and more hostile to diversion? I have yet to speak about diversion, but that is what Bill C-5 called for, diversion measures.
To continue with the U.S.-Portugal comparison, Portugal had one million heroin addicts and a shocking public health problem surrounding HIV transmission. They decriminalized, but they did not put the cart before the horse. They did not simply ease their consciences by going the diversion route and standing pat. We must invest money, redouble support measures, and hire social workers, frontline workers and street workers. More controlled-supply centres are needed, and we must constantly adapt and course-correct.
I see people saying that the BC pilot project is terrible. It is indeed terrible, but is it the decriminalization that is terrible? No, it is the fact that they are facing a crisis that no one here would be able to solve with a snap of their fingers. Everyone needs to work together. Yes, the people in British Columbia need to make some changes, but decriminalization does not necessarily mean people can use wherever they want. This can be regulated. I imagine this is where they are headed. Furthermore, there can be no denying the problems of sharing spaces with the community.
I made myself a crib sheet about the legal pillar. We were taught this in criminology back in the day. At one end, there is criminalization. At the other end, there is legalization. That is a spectrum. On the criminalization side, there is the death penalty. Is there a more severe punishment than a death sentence? Then there is incarceration, followed by fines.
Next up, we slowly go into the diversion and decriminalization spectrum. This could involve supervised consumption, the possibility of diverting the person before the courts, targeted interventions by the police, formal cautions, administrative penalties and fines. There can be decriminalization of simple possession, which is not yet legalization. Next, there is regulation of retail sale and of commercial production, and then legalization. That is legalization. One can say that this constitutes a spectrum.
When I hear the opposition leader say it is all the same thing, I have to tell him no, it is not the same thing. There are tables available. A little reading would help. It is as though I said that the death penalty was the same as incarceration. No, there are different measures, there is differentiation within the decriminalization spectrum, including diversion measures. This is what Montreal and Quebec have gone with, diversion.
Bill C‑5 contained an important provision that included a diversion measure for simple possession offences. Among other things, it led to the implementation of the pilot project in British Columbia, which started in January 2023 and just ended. Has it really ended? The answer is yes and no, because I expect they are going to make the necessary adjustments.
For anyone who is unaware, this crisis has been growing since 2016 and spiked during the pandemic. Why? Because people were isolated then. When someone overdoses while they are alone, they cannot self-administer naloxone. Furthermore, unless people use in supervised consumption sites, they cannot get naloxone.
The motion is incorrect. Let us examine point (a).
(a) proactively reject the City of Toronto's request to the federal government to make deadly hard drugs like crack, cocaine, heroin, and meth legal;
The statement is incorrect. Last January, the City of Toronto submitted a new version of its drug decriminalization plan to Health Canada, and the city is working on decriminalization, not legalization.
(b) reject the City of Montreal's vote calling on the federal government to make deadly hard drugs legal;
Similarly, Montreal is working on diversion measures, in collaboration with police forces and public health, so that frontline workers, everyone together, can coordinate their work. There are problems, of course, but everyone needs to work together, and they will. However, we are a long way from decriminalization and even further from legalization.
(c) deny any active or future requests from provinces, territories and municipalities seeking federal approval to make deadly hard drugs legal in their jurisdiction;
Once again, this is ridiculous, utterly ridiculous. No one is talking about legalization, but rather decriminalization, and even then, not everyone is calling for decriminalization. Some jurisdictions have thought about the issue, have changed their minds and are choosing greater co-operation among stakeholders in the field, with diversion measures, to avoid clogging up the courts with people who really should not be in prison but should be getting treatment, because prisons are not therapeutic places. People are coming together to say that they will continue to work collaboratively to try to gradually resolve any issues they may have related to sharing a space in the community.
(d) end taxpayer funded narcotics and redirect this money into treatment and recovery programs for drug addiction.
This is basically saying that taxpayers are funding the opioid and overdose crisis. That is not what is happening. This program was put in place to prevent deaths, and evidence shows that safe supply is actually reducing overdoses right now. Imagine how much worse the crisis would be without it.
I have to stop there.
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- May/1/24 7:07:00 p.m.
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Madam Speaker, I will end the suspense by announcing right away that the Bloc Québécois will be voting in favour of the bill. Still, I would like to emphasize our reservations regarding the creation of multiple national strategies. First, they often disregard the jurisdictions of Quebec and the provinces. Second, they sometimes seem to disregard, or at least fail to take into account, what is already being done in Quebec.
The bill seeks to make the federal government the puppet master, when Quebec already has its own unique approach to treating traumatic injuries, which include brain injuries. We did not wait for a federal brain injury strategy before taking action. Let us look at what is in the bill. Let us examine the points one by one:
(a) promote the implementation of preventive measures to reduce the risk of brain injuries;
That is a good thing. Specifically as an employer, but also as a contributor to a number of organizations and events, the federal government must ensure that brain injuries are prevented as much as possible.
(b) identify the training, education and guidance needs of health care and other professionals related to brain injury prevention and treatment and the rehabilitation and recovery of persons living with a brain injury;
Training health care professionals falls to the provinces, to professional associations. Furthermore, brain injuries are treated by hospitals, which are also under provincial jurisdiction. Therefore, the federal government cannot identify anything, but it can certainly help identify needs and participate in the collective effort to address the concussion epidemic.
In order to address brain injuries, Quebec has its own organizational model, known as the trauma care continuum. This model has four objectives: accessibility, efficiency, quality and continuity of care and services. The program was implemented in the early 1990s and continues to evolve by encouraging co-operation mechanisms, research and an assessment process implemented with trauma care continuum assessment functions. This involves collaboration between Quebec's ministry of health, the Institut national d'excellence en santé et en services sociaux or INESSS, the Société de l'assurance automobile du Québec, and the Commission des normes, de l'équité, de la santé et de la sécurité du travail or CNESST.
Regarding brain injuries more specifically, Quebec also has an action plan for the prevention and management of concussions in sports and recreational activities, and it has had a concussion management protocol since 2019. The protocol includes a tracking sheet for recording information to be shared with participants, parents, and recreational, school or sports organizations, as well as health care system personnel. It outlines the steps to take based on a participant's condition after an incident, though it should not be used to diagnose a concussion and is not a substitute for a medical opinion.
I also want to note that Quebec and its specialists, like all the provinces of Canada, train their workers and establish guidelines for their professionals in the treatment of brain injuries. For example, INESSS partnered with the Ontario Neurotrauma Foundation to publish the Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to Severe TBI. The INESSS even has a tool called “Decision Algorithm for Serious Neurological Complication Risk Management Following MTBI, Adult Clientele” to assist professionals with their decision-making.
(c) promote research and improve data collection on the incidence and treatment of brain injuries and on the rehabilitation and recovery of persons living with a brain injury;
Promoting research is an essential role for the federal government. It is something the government is doing and should be doing. One example is Université de Montréal's research centre in the psychology department.
This Canada research chair in paediatric traumatic brain injury does rather extraordinary work and she does indeed receive funding. The chair is trying to better understand traumatic brain injury in young children.
(d) promote information and knowledge sharing with respect to brain injury prevention, diagnosis and treatment and the rehabilitation and recovery of persons living with a brain injury;
The promotion of information and knowledge here and abroad is a mission the federal government is asked to do and is participating in. For example, it is working with the Parachute organization on the publication of the Canadian guideline on concussion in sport.
(e) create national guidelines on the prevention, diagnosis and management of brain injuries in all communities, including recommended standards of care that reflect best methodological, medical and psychosocial practices;
As previously mentioned, Quebec already does this with its own model. As long as the federal government is trying to collaborate and not establish or impose, then we support the initiative.
(f) promote awareness and education with particular emphasis on improving public understanding and protecting the rights of persons living with a brain injury;
For an awareness campaign to be effective, it must be adapted to its context. Given that the Quebec government provides the services and resources, it is in the best position to run those campaigns. In fact, it is already doing just that. There are many websites and brochures available to the public that are designed to prevent or recognize the symptoms of brain injuries.
(g) foster collaboration with and provide financial support to national, provincial and local brain injury associations and brain injury service providers to develop and provide enhanced and integrated mental health resources for persons living with a brain injury and for their families;
If the federal government wants to use tax tools to help families facing additional costs or loss of income because of a brain injury, the Bloc Québécois invites Ottawa to do so. I would add that the EI reform promised by the Liberals has yet to happen.
(h) encourage consultation with mental health professionals, particularly in educational institutions, sports organizations and workplaces, to provide persons who are suffering from the effects of a brain injury, including mental health and addiction problems, with a support system within the community;
Encouraging consultation is all well and good, but where mental health is concerned, access is the problem. Quebec lacks the resources needed to train more psychologists and social workers. It also needs resources to provide better working conditions for its professionals to retain them in the public system and in community organizations. If the federal government wants to financially support our health care systems, it will come as no surprise to anyone that increasing health transfers is the way to go about it. The Bloc Québécois supports that.
The Bloc Québécois would remind members that one of the major problems with Canada's health care systems is federal government under-investment. The federal government needs to increase transfers to 35%.
(i) identify challenges resulting from brain injury, such as mental health problems, addiction, housing and homelessness issues and criminality, including intimate partner violence, and work to develop solutions in collaboration with stakeholders;
Health, including mental health, falls under provincial jurisdiction. The same goes for addiction, housing and homelessness. If the federal government wants to fund research on those topics, then we invite it to do so. When it comes to criminality and violence, that is an area in which the federal government can and should take action.
(j) maintain, in collaboration with Brain Injury Canada, a national information website providing current facts, research and best practices related to the diagnosis and management of brain injuries, as well as other relevant resources;
When I read that, I found it a bit strange that a bill would explicitly give an organization the responsibility to maintain a website on brain injuries. In any case, we believe that Quebec and the provinces are in the best position to inform people of the resources that are available and of the action they should take if they experience a brain injury.
(k) establish a task force to include policy makers, stakeholders, community agencies, brain injury associations and Indigenous groups, as well as persons who have experienced a brain injury and their families, to make recommendations in relation to the national strategy.
We agree on that, and as I said earlier, we look forward to taking this to committee so we can make some adjustments. Then we can vote in favour of the bill.
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